West Midlands Transfer Service Cooling Figures Oct 11 – Mar 12 Transport User Group April 2012

Referrals for Cooling 12 transfer requests 12 transfer requests 1 transfer cancelled by referring unit; 1 transfer cancelled by referring unit; Referring consultant cancelled transfer as baby already receiving active treatment on cooling mattress. 1 transfer cancelled by NTS; 1 transfer cancelled by NTS; Referral from CENTRAL network to transfer into SWM network, NTS on ITU job therefore transfer performed by CENTrE.

Transfer Request Demographics SWMNN = 8 (80%) SWMNN = 8 (80%) SSBCNN = 2(20%) SSBCNN = 2(20%)

Cooling Centre Demographics Cancelled transfer by NNU = Heartlands Cancelled transfer by NNU = Heartlands Cancelled transfer by NTS = Heartlands Cancelled transfer by NTS = Heartlands

Babies Age at Time of Referral Cancelled by NNU = >12hrs Cancelled by NNU = >12hrs Cancelled by NTS = ? Cancelled by NTS = ?

NTS Response Time From time of referral call to NTS arrival on referring neonatal unit From time of referral call to NTS arrival on referring neonatal unit Within 2 hours= 6(60%) Within 2 hours= 6(60%) 2 – 3 hours= 2(20%) 2 – 3 hours= 2(20%) 4 hours + = 2 (20%) 4 hours + = 2 (20%)

Babies Age at Cooling Centre Case A & B = Transfer >12hrs old, babies already receiving active cooling therapy. Transfers due to cot management.

Babies Age when Therapeutic Hypothermia Achieved (33-34º) 6 babies achieved therapeutic range within 6 hours. 6 babies achieved therapeutic range within 6 hours. 1 baby achieved therapeutic range within 8 hours. 1 baby achieved therapeutic range within 8 hours. 2 babies never achieved therapeutic range during transfer process. 2 babies never achieved therapeutic range during transfer process.

Passive vs Active Most common techniques; Most common techniques; Cool water gloves (20%) Cold transwarmer (30%)  50% Passive Cooling  50% Active Cooling

Modes of Ventilation Inotropes used in 2 cases Inotropes used in 2 cases Phenobarbital used in 5 cases Phenobarbital used in 5 cases Morphine used in 16 cases Morphine used in 16 cases

Plans For The Future Training and education; Training and education; Delivery Room/Initial management Delivery Room/Initial management Rectal temp monitoring Rectal temp monitoring Documentation Documentation New transport cooling mattress. New transport cooling mattress. New transport cooling guidelines. New transport cooling guidelines.

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